Awake During Surgery
This was the first time I went under the knife without general anesthesia
There is no way to prepare yourself for a surgery that you will not be unconscious for. I was told that there would only be a local anesthetic and some light sedation to have a wire surgically implanted in my shoulder to be connected to an external device to reduce the shoulder pain I have had for 20 years:
I was willing to try anything. The device sounded promising. Other patients had had success with it. The claim was that the procedure would take 20–30 minutes. We can put up with anything for 30 minutes.
I had jumped through countless hoops to make this surgery happen:
Finally, the day had come. The hospital was not able to tell me where or when I would have the procedure until the day before. I knew it would be in inconvenient New York City during grid lock alert month, but wasn’t able to plan my trip until the day before. I also received a call that day from the surgeon’s office to explain that my secondary insurance did not have out of state benefits. Good to know the day before a procedure that I’d had the consult for over a month ago at which time they were given my insurance information. No one could tell me the cost of the procedure or the device ahead of time. I was told to check into the hospital by 9:30 in the morning.
While we stood at the security desk in a New York City hospital showing our ID and having our photos taken, a big dirty looking man came in off the street and proceeded to walk past the security desk. An agent on the other side of the desk called out, “Sir, excuse me, sir!” She was loud but he didn’t seem to hear her. He started talking to another man who was seated behind security. The agent walked up to him. He told her he needed her to call the police for him. She said she couldn’t do that for him, but if he needed a doctor he would have to walk around to the emergency room. It was an interesting city drama, but I had no time to waste to see how it would turn out. I had arrived ahead of schedule, and didn’t want to fall behind now.
I arrived at the admitting department by 8:30. I knew there would be paperwork. I have spent an inordinate number of days in hospitals so I know nothing happens quickly there. Still, I expected an early start might mean being discharged during light of day.
By 10:00 I was called by a nurse to go upstairs to the pre op area. The nurse was very friendly and I was probably nervous so I made a lot of chit chat on the way up with him. He checked on what I was wearing underneath my clothes. I’d skipped a bra because I knew it might be hard to put it back on with incisions in my shoulder later.
The nurse put me in a bed in pre op and proceeded to get me out of my clothes and into a gown. I got special socks that were color coded “Fall Risk” to match the bracelet they put on so nurses or anyone would know just by looking at me that I don’t get up and walk normally.
The nurse, Beverly, who had called the day before with my instructions tended to me with loads of questions. She took my blood pressure and temperature. The other nurses were also friendly. A few of them commented on how much they loved my hair. It was especially messy because I didn’t wash it before going to the hospital. This was the umpteenth reminder that my hair always looks good even if I don’t think it does.
When Beverly asked about my alcohol consumption habits she needed to know when I’d had my last drink. “I had a shot of bourbon last night.” Another nurse overheard and got a big kick out of this. She came over to my bed and wanted to hear all about it. I told her I had indulged in a delicious meal at a restaurant the night before for my “last meal.” There was to be nothing to eat or drink after midnight that night. She listened with great enthusiasm to my description of my meal, and how I’d mixed the bourbon with hot cider and orange juice.
Hours dragged by. I was hungry, thirsty, and had a headache from caffeine withdrawal. The surgeon popped in and said hello, then whizzed away. I was expecting a visit from the anasthesiologist. I’d been in this bed before. Beverly offered me some water that I could rinse my mouth with and then spit it out.
At 11:30 the surgeon popped back in to tell me I was next.
By 12:00 the anesthesiologist finally came to interview me. He explained that the surgeon would give me a local anesthetic to numb my shoulder and he would put in an IV for medication. I asked him what he was going to give me. He asked me what I wanted. I was just curious about what to expect. I didn’t know what I wanted. He told me he was going to give me Verced and Fentanyl. I knew these were strong medicines so I was expecting a peaceful time in the operating room.
The surgeon arrived with a rep from the manufacturer of the device. They briefly explained what they would do and how it would work. I needed to sign something to give the rep permission to attend my surgery. I asked the surgeon if he was going to wash his hands first.
His response was interesting. He raised the question of what will we find out we were doing wrong today in the future just as no one knew at the start of the Civil War that not washing hands was causing deadly infections.
The ride on your back on a hospital gurney is always interesting. There is an awareness of traveling quickly without any effort or volition of your own to a mysterious destination. I like to look around operating rooms before being sedated. I’m fascinated by the overhead lights with their mega wattage bulbs. I asked the surgeon if he was going to use those big lights overhead. He said they would have to turn off the lights because they interfere with the ultrsound images he needed to find the nerve in my shoulder to implant the wire.
There were about 8 people in the OR. I was introduced to several nurses and assistants but knew I didn’t have to retain their names. I asked if everyone had washed their hands. I noticed the clock on the wall said 1:00.
The surgical team maneuevered me onto my right side and propped up my left arm and head with pillows. I felt like a piece of meat. The anesthesiologist put some oxygen in my nose and connected a tube to the IV in my hand. I was hoping to relax.
They covered my head with some paper drapes, and put warm blankets over my body. It was cold in the OR so this was welcome at first.
The surgeon told me they would be talking to me throughout the surgery to ask about how the device was working or not.
He warned me I would feel a pinch and some burning in my shoulder when he injected the anesthetic. It did pinch and burn then I expected to feel numb. I did not.
I also never felt relaxed by whatever was fed into the IV.
The surgeon told me I would feel pressure. I knew this was code for being cut with a knife. I did feel pressure but also felt severe searing pain. I told the doctor that it hurt. He said he was sorry but he was almost done. He was lying.
At one point I heard him tell the manufacturer’s rep that he wanted to test the placement of the wire. I felt a pleasant tingling that seemed to obscure the pain in my shoulder. There was another trial of the motor control setting that activated my long paralyzed and greatly weakened muscles in my shoulder. It hurt but gave me hope that this thing would work once they got the wire in the right place and programmed the machine for my use.
The surgeon dug 2 more holes in my shoulder to try to get the best placement. The pain was unreal. I took a lot of deep breaths. It started to get hot under the tent where they’d buried my head. There were 1 or 2 seconds when I thought I would not be able to lie still until they were finished. I imagined how I could get out of being strapped down on an operating table with an IV in my hand, and possibly a scalpel in my shoulder. It would have been hard for me to get off the table even if I wasn’t being operated on because of my disability. I took more deep breaths.
When they uncovered my head, I told the doctor that he hurt me. He said he knew that he did, but he wasn’t happy with the first 2 placements and had to dig around more than expected. The clock on the wall read 3:00. I had stopped thinking about food and coffee. This had been the longest half hour of my life because it was really 2 hours. The doctor explained that he wasn’t happy with the result of the first placement and had to try 2 more spots until it was right.
I felt fine and wanted food. I’d been up since 5:30 AM. I had another mystery ride on a gurney that took me to the recovery room. I didn’t feel like I needed to recover from the anesthesia, but hospital protocol did.
The doctor and the manufacturer’s rep came to talk to me about how happy they were with the final placement of the wire. I was finally given some water that I could actually swallow.
When the nurse was happy with my blood pressure taken both lying down and standing, I was allowed to go to the bathroom.
Then they let me walk to the recliner chair in the kitchen where they gave me an egg salad sandwich and a cup of tea. One of the nurses asked if I wanted something for the pain. She gave me liquid Tylenol that was supposed to be longer acting than the pills.
It was 4:30 PM when we got in the car to start sitting in traffic to get home. So much for expecting an early finish for something that began early in the morning. Nothing happens quickly in a hospital.
I’ve been very sore since getting off that operating table. I’m just glad the worst is over. I’m looking forward to going back in 2 weeks so the doctor can see how I’ve healed and they can turn on the device and program it to hopefully give me some relief from this pain I have had for 20 years.
Thank you for reading :)